What is the role of tetanus immune globulin (TIG) in the treatment of tetanus (lockjaw)?

Updated: Jan 18, 2019
  • Author: Patrick B Hinfey, MD; Chief Editor: John L Brusch, MD, FACP  more...
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Answer

Tetanus immune globulin (TIG) is recommended for treatment of tetanus. It should be kept in mind that TIG can only help remove unbound tetanus toxin; it cannot affect toxin bound to nerve endings. A single intramuscular (IM) dose of 3000-5000 units is generally recommended for children and adults, with part of the dose infiltrated around the wound if it can be identified.

The World Health Organization recommends TIG 500 units by IM injection or intravenously (IV)—depending on the available preparation—as soon as possible; in addition, 0.5 mL of an age-appropriate tetanus toxoid−containing vaccine (Td, Tdap, DT, DPT, DTaP, or tetanus toxoid, depending on age or allergies), should be administered by IM injection at a separate site.

Tetanus disease does not induce immunity; patients without a history of primary tetanus toxoid vaccination should receive a second dose 1-2 months after the first dose and a third dose 6-12 months later.


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